1396005625 NPI number — LAURIE ANNE ATEN, MD, PLLC

Table of content: (NPI 1396005625)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396005625 NPI number — LAURIE ANNE ATEN, MD, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAURIE ANNE ATEN, MD, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ATEN WOUND CARE & HEALING CENTER, PLLC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396005625
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8440 WALNUT HILL LN
Provider Second Line Business Mailing Address:
STE 120
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75231-3833
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-506-2610
Provider Business Mailing Address Fax Number:
214-506-1170

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2817 S MAYHILL RD
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
DENTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76208-5966
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-220-0887
Provider Business Practice Location Address Fax Number:
940-220-0893
Provider Enumeration Date:
05/21/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ATEN
Authorized Official First Name:
LAURIE
Authorized Official Middle Name:
ANNE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
940-220-0887

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  J0428 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2083A0100X , with the licence number: J0428 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2083P0011X , with the licence number: J0428 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com